| NPI | 1922060268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD450432) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01055628A) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 47529) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47529) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2015-10-26 |